Partisanship puts Dems in peril

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In an Ideas piece, Holtz-Eakin says partisan health care reform efforts by Democratic presidents in 1993-94 and 2009 failed to win the confidence of the American people and sufficient votes in Congress.
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Why entitlement and delivery system reform first? A “cost-first” rather than “coverage-first” approach will ensure that coverage expansions are fiscally sustainable. These reforms should include revamping the payment schemes for Medicare and Medicaid, paying for quality rather than quantity of services; mandating transparency in pricing in health care markets; improving information and electronic infrastructure; rewarding patients who seek out the most cost-effective care; and medical malpractice reform.

Turning to insurance, Republicans must acknowledge that universal coverage is the goal — but a goal that will be state-based and phased in over time as entitlement reform frees up funding for extending coverage through high-quality private insurance. Individual states should have the freedom to achieve coverage expansions through state-specific mechanisms (like the Massachusetts mandate) but must be held accountable for achieving those expansions. By relying on gradual, state-based experiments, the nation will have an opportunity to see what approaches work best.

Any necessary federal financing should be realistic, without relying on gimmicks like “super committees” or “automatic” cuts in provider and hospital reimbursements that will never survive.

What does each party gain? Democrats will achieve their campaign promise by putting the nation on a path toward universal coverage. The president will finally get the bipartisan legislation that he promised when he took office. Republicans will burnish their credentials as stewards of good, fiscally sustainable government and middle-class concerns.

Obamacare is over, but the health care reform effort doesn’t have to be — provided bipartisan policy and politics leads the way.

Douglas Holtz-Eakin is a former director of the Congressional Budget Office. He is a fellow at the Manhattan Institute and president of DHE Consulting in Arlington.

You ALREADY have a rationed healthcare plan. You will probably get less rationing from a public option than you do from your private insurer... since there is no profit to be made. Besides, the public when polled about a public option, not about a healthcare plan, are in favor by a large margin. So whatever the reform is, it must include a public option because it is what the majority want.

We want TORT REFORM to get rid of the ambulance chasing

trial lawyers .

Amazing how the fringe rightwing loons seem to live in some kind of imaginary beckland where reality does not apply.

The majority just wants costs to be controlled. For every poll saying that people want a gov option there's another one showing people don't want it. If a gov option is anything like Medicare then count me out. I've delt with Medicare and I've found it is lacking. Unless you have no money what so ever you need Medigap to cover the difference then you are still stuck with the difference between what Medicare says it should cost and the real cost.

I agree Obama could have made this work but his input has been lacking. He's turning out to be one of the worst presidents we've had. His leadership is limited to calling people into his office and saying "come on, come on" and when they don't he throws up his hands and says "I tried". If he was to lead, like Doug said, pick out some moderates from both sides and let them hammer out a series of plans. He could have sat down with them and came up with clear goals that both sides supported. If there was something one side wanted then it's his job to make the otherside accept it (by finding something it wants). It should be done in steps so if one part does't work then it can easily be fixed or killed.

Instead Obama would rather stay in campaign mode and give speeches. He would rather single out those who don't agree with his views like a little kid and try to villinize somebody (it's part of being stuck in campaign mode). Too bad really, I had hopes he would have been much better.

The dems promised bi-patisanship as a means to solve the issues this country faces when they were campaigning. Huge numbers of independent bought that line of crap and gave the dems major victories in the last election. Now that the dems have taken the attitude that "we won the election, we can do what we want, you can't stop us so just get over it" they are losing independents in massive numbers.

Nancy "the torturer" Pelosi promised bi-partisanship in the campaign, but now takes great joy in the fact she can stop republicans from even attending her closed door meetings on legislation, let alone have any input in the process. The ego of the democrat congress may be good for their self esteem, but it is causing independents to run away in huge numbers.

You ALREADY have a rationed healthcare plan. You will probably get less rationing from a public option than you do from your private insurer... since there is no profit to be made. Besides, the public when polled about a public option, not about a healthcare plan, are in favor by a large margin. So whatever the reform is, it must include a public option because it is what the majority want.

It will be more rationed in the view of the user. There will be a panel that decides what treatments are acceptable for each specific ailment. This is the "Death Panel", that the left said was not there. While the name is a misrepresentation it is in the plan, this panel will get in the way of what you and your doctor wants to do with treatments, instead of after the treatment plan is already established. Be careful of he polls you quote, the ones I see that ask about the public option are all taken in the cities of the NE, hardly represenative of the nation as a whole.

Another Non-issue... the CBO estimates that Tort-Reform would save the incredible amount of 0.5% of the current healthcare expediture!!

Actually you are wrong, there was a pilot program that was ran in Texas and California that realized a 30-40% savings on insurance premiums for the user. Was this not a reason Obama wanted to enact reform, to lower costs to the user? Therefore it is a large issue, unless of course you are blindly following instead of thinking critically. Before you ask me to show proof, I will direct you to google, the information is hardly hidden.

Amazing how the fringe rightwing loons seem to live in some kind of imaginary beckland where reality does not apply.

Funny how the left does not want to debate, but degrade. Are they having problems with thier ideas, do they stand up to scrutiny? Remember, ridicule is the fortress of the inbecile.

So much dreck on the page. Making deals with Republicans is like hugging a suicide bom-ber. TALK ABOUT INSANITY!

Does that seem harsh? A couple months ago, some idiot skimmed through the House Bill and send out an email just full of logical and factual errors. For example, the "gentleman" said that the legislation prohibited the sale of all private insurance after a set date!

This junk was investigated by factcheck.org (and all the other neutral fact check organizations) and they found every single thing this "gentleman" said was WRONG, with the exception, I believe, of 7 items (out of over 100).

DID THIS STOP REPUBLICANS FROM QUOTING this junk? Of course not.

Then a few enterprising nut-jobs came up with the "death panel" charge. Again, this was completely debunked by the facts.

DID THIS STOP REPUBLICANS FROM QUOTING this junk? Of course not.

WHERE ARE THE REPUBLICAN SOLUTIONS? Oh, I know, if we pass punitive "tort reform", that substantially undermines victims' rights, the sun will break out, we will join hands and start to sing together!

EXCEPT, conservative states like Missouri have ALLREADY TRIED THIS. Conservative state legislators, led by conservative Governors, passed harsh tort reform legislation. Did this reduce the cost of health insurance in these states at all? NOPE.

WAIT, WAIT! No, to make the sun break out, we have to "allow people to buy insurance across state lines". BUT what the frak is stopping them now? Answer: Not federal law.

THE FACT IS that health insurance, like marriage, is regulated on a state by state basis. This means that Texas can choose to have laws that really screws patients at the same time Massachusetts has fairly strong consumer protections.

THIS IS WHAT YOU CALL FEDERALISM!

But now, Republicans want YOU to lose the protections afforded by state law. THEY WANT THE WEAKEST STATE LAWS TO OVERRULE WHAT YOUR STATE PASSES. (All an insurance company would have to do is move its incorporation to the state with the weakest consumer protections. This is how things work for credit cards.)

And how are residents of Iowa supposed to get any consumer protections, if the controlling law is that the stuff passed by Texas.

here is one question of a recent poll in Maine, featured here on Politico (Live Pulse: Mainers like a public option October 15, 2009)

Pan Atlantic SMC group poll:

"Would you favor or oppose the government offering everyone a government administered health insurance plan ? something like the Medicare coverage that people 65 and older get ? that would compete with private health insurance plans? [Options were rotated]"

October 2009

Favor 57.4% Oppose 37.2% Don't know 5.5%

Nearly six in ten (57.4%) Maine citizens polled favor the government offering a government administered health insurance plan that would compete with private health

I tend to lean Republican but on health care I find the argument very compelling that there are countries that have single-payer systems that work very well, so I would go for such a system here.

HOWEVER. Even if there were sufficient public support for single-payer, I have absolutely zero confidence that the likes of Nancy Pelosi and Max Baucus could produce a viable single-payer system.

Just because single-payer systems CAN work well doesn't mean that Congress is competent enough to construct one.

And, to make matters worse, there is no public consensus on single-payer, so instead we will have some sort of legislative hairball that may or may not contain a "public option", but either way will be a convoluted mess.

So you have the toxic combination of an incompetent Congress and a political climate that BOTH lead to the result that if they are able to successfully get a bill into law that produces a major overhaul of the health care system, it is guaranteed to be a policy fiasco of gargantuan proportions.

What a ridiculous article. The Dems have tried, unsuccessfully, to work with the republicans. The republicans have made it VERY clear that their sole goal is to defeat President Obama on anything and everything he proposes. I believe they feel, according to one representative, that defeating the president would be a "water loo" for them. Any republican who has shown an interest in actually working for a common goal for health care reform (Snowe) is immediately and savagely berated by her fellow republicans. They want to destroy the president, nothing more. The Dems have the majority--I say grow a spine and work for the good of the people. We cannot waste anymore time with the childish and petulant republicans. A bunch of sore losers who cannot STAND that they are out of power.

I tend to lean Republican but on health care I find the argument very compelling that there are countries that have single-payer systems that work very well, so I would go for such a system here.

HOWEVER. Even if there were sufficient public support for single-payer, I have absolutely zero confidence that the likes of Nancy Pelosi and Max Baucus could produce a viable single-payer system.

Just because single-payer systems CAN work well doesn't mean that Congress is competent enough to construct one.

And, to make matters worse, there is no public consensus on single-payer, so instead we will have some sort of legislative hairball that may or may not contain a "public option", but either way will be a convoluted mess.

So you have the toxic combination of an incompetent Congress and a political climate that BOTH lead to the result that if they are able to successfully get a bill into law that produces a major overhaul of the health care system, it is guaranteed to be a policy fiasco of gargantuan proportions.

DO REPUBLICANS even care if their "ideas" stand up to facts? Let's find out:

Tom Baker, a professor of law and health sciences at the University of Pennsylvania School of Law and author of “The Medical Malpractice Myth,” who believes that making the legal system less receptive to medical malpractice lawsuits will not significantly affect the costs of medical care. He spoke with the freelance writer Anne Underwood.

Q. A lot of people seem to have taken up the cause of tort reform. Why isn’t it included in the health care legislation pending on Capitol Hill?

A. Because it’s a red herring. It’s become a talking point for those who want to obstruct change. But [tort reform] doesn’t accomplish the goal of bringing down costs.

Q. Why not?

A. As the cost of health care goes up, the medical liability component of it has stayed fairly constant. That means it’s part of the medical price inflation system, but it’s not driving it. The number of claims is small relative to actual cases of medical malpractice.

Q. But critics of the current system say that 10 to 15 percent of medical costs are due to medical malpractice.

A. That’s wildly exaggerated. According to the actuarial consulting firm Towers Perrin, medical malpractice tort costs were $30.4 billion in 2007, the last year for which data are available. We have a more than a $2 trillion health care system. That puts litigation costs and malpractice insurance at 1 to 1.5 percent of total medical costs. That’s a rounding error. Liability isn’t even the tail on the cost dog. It’s the hair on the end of the tail.

Q. You said the number of claims is relatively small. Is there a way to demonstrate that?

A. We have approximately the same number of claims today as in the late 1980s. Think about that. The cost of health care has doubled since then. The number of medical encounters between doctors and patients has gone up — and research shows a more or less constant rate of errors per hospitalizations. That means we have a declining rate of lawsuits relative to numbers of injuries.

Q. Do you have numbers on injuries and claims?

A. The best data on medical errors come from three major epidemiological studies on medical malpractice in the 1970s, 1980s and 1990s. Each found about one serious injury per 100 hospitalizations. There hasn’t been an epidemiological study since then, because people were really persuaded by the data and it’s also very expensive to do a study of that sort. These data were the basis of the 1999 report from the Institute of Medicine, “To Err Is Human.”

Q. And what percent of victims make claims?

A. Those same studies looked at the rate of claims and found that only 4 to 7 percent of those injured brought a case. That’s a small percentage. And because the actual number of injuries has gone up since those studies were done — while claims have remained steady — the rate of claims is actually going down.

Then a few enterprising nut-jobs came up with the "death panel" charge. Again, this was completely debunked by the facts.

As I stated above, I noticed you answered one of my posts but did not address this one, cherry picking, while it is misnamed, there is provision for a panel that will regulate what treatments apply to certain ailments. This panel will still stop your doctor and you deciding on a appropriate treatment plan for you.

WAIT, WAIT! No, to make the sun break out, we have to "allow people to buy insurance across state lines". BUT what the frak is stopping them now? Answer: Not federal law.

THE FACT IS that health insurance, like marriage, is regulated on a state by state basis. This means that Texas can choose to have laws that really screws patients at the same time Massachusetts has fairly strong consumer protections.

THIS IS WHAT YOU CALL FEDERALISM!

Now it is funny for a liberal to say the word "FEDERALISM", since they do not want that, it goes against the big government ideals. But regardless of that, your argument is flawed. The Comerce Clause allows the federal government to allow trading of insurance packages accross state lines, the states can govern thier health care laws as they see fit but congress can force them to let all players in. This would allow for more choice, one of the targeted goals as said by Obama. In addition this will remove the anti-trust neds that the insurance industry currently enjoys and then the Congress can affect how the companies treat thier patrons. Simple really.

Missouri Tort Distortion was passed by Republicans in 2005. It was no trial program, but included the entire state.

HEALTH INSURANCE RATES ARE GOING UP THERE AT THE SAME RATE AS BEFORE THE "REFORM".

I have no doubt that Doctor's benefited financially. TOO BAD THIS IS ON THE BACKS OF THE MALPRACTICE VICTIMS!

Tort Reform == BAD DOCTORS should not have to pay anything to their victims. So much personal responsibility.

Such anger, well here goes. I have no idea what the Missouri version of tort reform was, I just know that the trials in Texas and California accomplished the goals of Obama, to lower costs to Americans. Tort reform does not have to further victimize malpractice sufferers. You could simply add a second phase of the trial, much like for wins and punitive measures phase, for those who lose thier trial. This phase would determine by jury if the litigation was frivolous, if it was found to be such then the lawyer who brought the case, not the litigant, would be liable for all court costs. This would ensure that lawyers do not bring cases that do not have merit, while allowing cases that do. To say that an idea is completely wrong without looking at the ways it could be done is living life with blinders on, and you all are supposed to be the party of visionaries.

BTW, the tone of your posts and the name calling is not needed, debate helps, ridicule does not. Remember ridicule is the fortress of the inbecile.